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The use of an internet-based ask the doctor service involving family physicians: evaluation by a web survey
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
Mid-Sweden Research and Development Centre, County Council of Va¨ sternorrland, Sundsvall, Sweden.
Health Institute, Department of Health and Behavioural Science, University of Kalmar, Sweden.
2006 (English)In: Family Practice, ISSN 0263-2136, E-ISSN 1460-2229, Vol. 23, no 2, 159-166 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Internet consultation without a previous relationship between the doctor and the enquirer seems to be increasing in popularity. However, little is known about the advantages, disadvantages or other differences compared with regular health care when using this kind of service. OBJECTIVE: To investigate how an Internet-based Ask the Doctor service out with any pre-existing doctor-patient relationship was used and evaluated by the enquirers. METHODS: We recruited to a web-based survey users of the non-commercial Swedish Internet-based Ask the Doctor service run by family physicians. The survey was conducted between November 2001 and January 2002. Questions included both multiple choice and free text formats, and the results were analysed quantitatively and qualitatively. RESULTS: The survey was completed by 1223 participants. It was mainly women who submitted questions to the service (29% men, 71% women) and also who participated in the survey (26% men, 74% women). Most participants (77%) wrote their question at home, and 80% asked on their own behalf. Almost half of the enquiries (45%) concerned a medical matter that had not been evaluated by a medical professional before. After reading the answer, 43% of the participants indicated that they would not pursue their question further having received sufficient information in the answer provided. The service was appreciated for its convenience and flexibility, but also for reasons to do with the mode of communication such as the ability to reflect on the written answer without having to hurry and to read it more than once. CONCLUSION: In the present study, we found that an Internet-based Ask the Doctor service run by family physicians on the whole was evaluated positively by the participants both in terms of the answers and the service. Internet-based consultation may act as a complement to regular health care. In future studies, the cost-effectiveness, patient security, responsibilities of the Internet doctor and the role of Ask the Doctor services compared with regular health care should be evaluated.

Place, publisher, year, edition, pages
2006. Vol. 23, no 2, 159-166 p.
Keyword [en]
Access to Information, Adolescent, Adult, Aged, Child, Data Collection, Female, Humans, Internet, Male, Middle Aged, Physician-Patient Relations, Physicians; Family, Remote Consultation/*utilization, Sweden
National Category
Family Medicine Other Medical Engineering Computer Science
URN: urn:nbn:se:umu:diva-6319DOI: 10.1093/fampra/cmi117PubMedID: 16464871OAI: diva2:145988
Available from: 2007-12-08 Created: 2007-12-08 Last updated: 2011-10-14Bibliographically approved
In thesis
1. Internet consultation in medicine: studies of a text-based Ask the doctor service
Open this publication in new window or tab >>Internet consultation in medicine: studies of a text-based Ask the doctor service
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to cast light on the new phenomenon of Internet-based medical consultation. This was approached by studies of the use of an Ask the doctor service, by a web survey to the users who sent enquiries to the service, and by a questionnaire to the answering physicians of their respective expericence of the service.

Written communication is becoming increasingly important, not only for communication between individuals outwith health care (e.g. by email, SMS and instant messaging), but also between doctors and patients. There is an ongoing shift in the way individuals look for medical information with an increasing number going first to the Internet berfore talking with their physicians. Also, there is an increasing interest from patients in accessing Internet-based services, including text-based consultations with doctors. These consultations can be part of the regular communication between a patient and his/her doctor or be carried out without any previous relationship. Our studies of the latter consultation type emanate from the free of charge Ask the doctor service at a Swedish public health web portal, Infomedica, financed by health authorities. At the Ask the doctor service, the communication has been merely text-based and the individual using the consultation service (here called the enquirer) might have been anonymous.

We followed the development of the first four years use of the service (38 217 enquiries), finding that the typical enquirer was a woman aged 21-60 years. Three quarters of the enquirers were women, thus exceeding the gender difference seen in regular health care. The service was used all times of the day and night, seven days a week, and it was most used in densely populated areas as defined from postal codes.

The enquiries submitted to the service included a broad variety of medical issues. Most enquirers asked on their own behalf. Almost half of the enquiries concerned a matter not previously evaluated by a medical professional. Only a few were frequent enquirers. The service was used e.g. for a primary evaluation of a medical problem, for getting more information on a medical issue under treatment, and for a second opinion. The most common reasons for turning to a doctor on the Internet were convenience, wish for anonymity and that doctors were experinced too busy. In free text a considerable number of participants expressed discontent and communication problems with a previous doctor as a reason to turn to the Ask the doctor service. Many participants expressed a view of the service as a complement to regular health care, and the majority were satisfied with the answer. Nearly half of the participants in the web survey stated that they received sufficient information in their answer and that they would not pursue their question further.

The family physicians answering the enquiries at the Ask the doctor service were stimulated and challenged by the new task, in spite of the limitations caused by the lack of personal meetings and physical examinations. The opportunity to reflect on the answer before replying was appreciated, and the task was regarded as having a high educational value for themselves.

The Internet not only allows easy access to medical information but also to medical consultation – to date mostly text-based. It is probable that in the near future an increasing number of doctors will adopt text-based communication via the Internet to be a natural part of their communication with patients. Therefore, training in text-based communication and carrying out Internet consultations should be integrated into the curricula of medical schools and of continuous professional development. Ethical guidelines should be established.

Place, publisher, year, edition, pages
Umeå: Umeå University, 2006. 64 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 1034
Internet, remote consultation, physician-patient relations, gender, access to information, ethics
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
medicinsk informatik
urn:nbn:se:umu:diva-854 (URN)91-7264-123-1 (ISBN)
Public defence
2006-10-06, Hörsal Betula, 6M, UMEÅ, 10:00 (English)
Available from: 2006-09-05 Created: 2006-09-05 Last updated: 2016-05-26Bibliographically approved

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